In the last decade, vaccine information management has slowly evolved from paper at every level in the health system, to Excel-based reports at higher levels (districts or above) that are emailed, to simple stand-alone databases with exported PDF reports, and most recently web forms that capture data and display essential dashboards online. Different countries are at different stages in this evolution, and most still rely on paper to capture data from health facilities and vaccination points.
In Tanzania, the Immunization and Vaccine Development (IVD) program uses all of these tools to manage its diverse data. But each of them—manual and electronic—are customized and unique to immunization program needs; none are in use in other health programs or commodity supply chains, even though the data needs and uses are similar. For example, stock management is a universal activity regardless of the product being stored, and equipment functionality and maintenance data is as essential to diagnostic equipment as it is to cold chain.
Within the IVD program, data is also collected and compiled in separate component-specific reports or databases that then require comparison, even though data for one specific component has direct impact on other components. Coverage data informs supply chain decisions; cold chain failures require a supply chain response. And IVD’s use of multiple reporting technologies and systems is not unique; as in many other countries, the multiplicity of data management initiatives and technologies in Tanzania has become difficult to manage across the entire health sector.
In response, The Ministry of Health and Social Welfare launched the eHealth strategy in 2011 to provide policy guidance and drive efficiencies and integration. The first manifestation of the strategy was in 2013 with the development of the electronic logistics management information system (eLMIS), an integrated online platform for managing all health commodity supply chain data. The open source eLMIS is integrated with the information system used by Medical Stores Department (the national supplier of health commodities to facilities), can operate offline as needed, and is deployed to all districts in the country. It includes a module for managing diagnostic and other medical and surgical equipment, including service contracts for maintenance and repair. It is able to exchange data through standardized application programming interfaces (APIs) with DHIS2, Tanzania’s national health information system.
But because of IVD’s unique needs, vaccines were not initially included in the eLMIS deployment, although the system was designed with vaccines in mind. Once eLMIS had proven its value and feasibility in the field, IVD was ready to engage with the eHealth strategy of greater integration and unified national technologies.
Through SCMS and the USAID | DELIVER PROJECT, JSI has been the principle technical partner (through USAID funding) supporting MOHSW’s development and nation-wide deployment of the eLMIS. With additional support from the Bill & Melinda Gates Foundation, JSI is working closely with IVD and other partners, including CHAI, PATH, and VillageReach, to create an integrated vaccine information management system (VIMS) that serves the unique needs of IVD. VIMS is a module within the eLMIS architecture but with many added features that deliver the full set of requirements IVD has identified. It brings together functionality from three stand-alone systems that are common in the immunization supply chain context; the district vaccine data management tool (DVDMT), stock management tool (SMT), and cold chain inventory tool (CCIT). VIMS is also designed with the APIs required to exchange data with DHIS2, the most common platform for health information systems in low-income countries.
The VIMS development partnership—IVD, JSI, CHAI, PATH and VillageReach—is unique, but essential. Each partner brings its own strengths and unique competencies, along with technical knowledge required to ensure that VIMS provides a robust array of functionality. JSI brings its deep knowledge of supply chain management and immunization programming, along with extensive software development and deployment experience. The entire VIMS project is managed through a steering committee, and is governed by a detailed project charter and workplan. Each organization has assigned resources and committed to time-bound deliverables, with JSI providing a system architect to manage the development process.
Although VIMS is still in development, preliminary functionality tests have been very promising, and not only for Tanzania’s immunization supply chain. VIMS has also set a new standard in integrated functionality that can be applied in any country context. VIMS launch is expected in the first quarter of 2016; stay tuned for more updates in the coming months.